Monthly Parking Application Form

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Colonial Parking, Inc. Monthly Parking Application And Guidelines
Location #
Employee Accepting Application
Today’s Date
Parking Activation Date
Assigned Acct #
Colonial Rep / Date processed
Access Card #
Additional Access Card #
For Corporate use only
Bill To:
Ship To:
Customer Name:
(complete if access card/ parking permit are to be mailed to different address)
Company/Organization (complete if to be sent to business address)
Ship To Street Address (including suite number)
Billing Street Address
City
State
Zip
/
/
City
State
Zip
Company/Organization Contact Name
/
/
Are you a TENANT of the building
Tax exempt:
(if yes, a copy of the Sales & Use tax exemption form must be provided with this applications)
Yes
 No
 Yes
 No
Tax Exemption Number #:
If yes provide the suite number/ Organization name
Business Phone
Home Phone
Email Address: (required for email notifications and receipts)
(
)
(
)
Permit/ Vehicle Information
Type permit requested (select type and quantity):
*Vehicle information: (required)
Primary Vehicle:
Alternate Vehicle:
Make: ______________
Make: ______________
Regular
Evening/ Night (where available)
Tag # ______________
Tag # ______________
Reserved
Tandem/Piggy Back/ Stacked
State: ______________
State: ______________
Color:
Color:
24 Hours (where available)
Payment Method (check one):
If you have additional vehicles please affix their information on a separate sheet of paper
AutoPay credit card
AutoPay ECheck
Payment for 1st month’s parking fee is due at the time of application submission.
 I acknowledge I have read and agree to the terms and restrictions of this Parking Agreement and Policy (* Required for Processing )
________________________________________________
_______
Signature:
Date:
Form: CCMA-1

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